POS1321 ABSENCE OF NAILFOLD CAPILLAROSCOPIC FINDINGS DEFINES A CLINICALLY DISTINCT SYSTEMIC SCLEROSIS SUBSET
Authors: L. Groseanu, N. Cristina, D. Nicoara, D. Opris Belinski, V. Bojinca, D. Predeteanu, F. Berghea, I. Saulescu, S. Daia-Iliescu, D. Mazilu, A. Borangiu, M. M. Negru, C. Cobilinschi, D. Mardale, C. L. Constantinescu, M. Duna, V. Vlad, M. Abobului, R. Ionescu, A. Balanescu
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> In systemic sclerosis (SSc), a specific nailfold videocapillaroscopy (NVC) pattern is observed in 90% of cases and seems to be associated with severity and progression of the disease. Data about SSc patients with normal/nonspecific NVC are scarce <sup>[1]</sup>. <h3>Objectives</h3> This study aims to investigate the clinical and immunologic characteristics of SSc patients with normal or nonspecific NVC and to compare them to those with a scleroderma NVC pattern. <h3>Methods</h3> This was a single-center retrospective study which enrolled 270 SSc patients referred for NVC since January 2000, in our rheumatology department. Demographic and clinical features, symptoms and parameters related to a specific organ involvement according to MEDS evaluation sheets and survival were evaluated. <h3>Results</h3> 270 SSc patients were selected in the database, from which we identified a final population of 19 (7%) patients with normal/nonspecific NVC pattern. The group comprised 14 females and 5 males, with a mean age of 52.7 (±17.4) years, most of them with diffuse subset (12/19). Among the cases, 8 (42%) had normal NVC and 11 (58%) had nonspecific NVC changes, characterized by isolated ramified capillaries in 42%, curved capillary limbs in 33%, giant capillaries in 16% and focal microhemorrhages in 9 % of patients. The mean Raynaud phenomenon's (RP) duration was longer (18.4 ± 14.4 years) compared to the other cases (10.2 ± 1.5 years). The difference was not significant (p=0.107). Significantly higher percentages of cases had lower overall frequency of digital ulcers (28% vs 51%, p=0.04). Presence of synovitis (p=0.010) and myositis (p&lt;0.001) was positively correlated with normal/nonspecific NVC changes. Regarding other organ involvement, the cases also had less severe pulmonary involvement, less frequent digestive involvement and/or pulmonary arterial hypertension than controls, but these differences did not reach significance. No differences in mortality were found between the groups. <h3>Conclusion</h3> SSc patients with normal/nonspecific NVC changes have less organ involvement and less overall disease severity than those with a typical SSc specific NVC pattern, with no between-group differences. Musculoskeletal involvement was the only factor independently associated with normal/nonspecific NVC. It is possible that SSc with normal NVC may be at lower risk of progression to severe visceral and skin involvements, but prospective studies are required. <h3>Reference</h3> [1]Cutolo M, Smith V. State of the art on nailfold capillaroscopy: a reliable diagnostic tool and putative biomarker in rheumatology? Rheumatology (Oxford). 2013 Nov;52(11):1933-40. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.